Friday, May 11, 2012

MAY 11, 2012


Well, this might be the hardest post to write up.  Not because I don't know the material, but because I know the material but don't like the facts.  I love the pictures (because Natty took them), but I don't like looking at them.  Knowing I'm fighting cancer is one thing.  It's a totally different thing to see myself as a chemo patient.  Does that make sense?  So, please bear with me as I work through some very difficult feelings (this may be random, and I apologize) while trying to give you a rundown of day one of chemo.

So, the day starts with me getting the kids off to school and mentally prepping them, reminding them that today is a "chemo day."  This discussion includes a reminder that I won't feel well, answering questions they ask, letting them know who will be picking them up from school, who will pick them up from daycare, who will get them dinner, etc.  There is a moment at school where I take a moment to hug them a little longer....I need the reassurance as much as they do, I think.

Day one of chemo is a very long day.  Assuming I've already done my lab work on a previous day, we cut about two hours off the schedule.  That's the new goal - to get my blood work done the day prior, so that they have the numbers they need before I meet with the med-onc (medical oncologist) team.  When they pull my blood, they run a lot of tests on it - CEA (my cancer marker), cbc (complete blood count, which is white, red and platelet counts), etc.  Those are the two that they normally pay attention to, or the two that I know for sure that they pay attention to.


As I said in an earlier post, one of the benefits (in my opinion) to being at CTCA is the ability (nee, requirement) to see your med-onc team prior to each and every chemotherapy session.  So, each infusion session starts out with a medical appointment.


Checking in at the clinic....this lady (whose name I can't remember) is awesome!  


 

When they walk you back, you get the typical vital check-up (height, weight, bp, etc.).  


 This is my cancer ass-kicking binder; yes, I've blinged it out and decorated it.  Did you doubt me?


And, yes, I have a list of questions.  For those that know me, this can't come as any kind of a surprise.

Then, there is a pretty specific schedule that we stick with - once the MA is done with the vitals, the med-onc team comes in.  My doc is Dr. Shildt (whom I adore) and he is accompanied by Roxanne, my care manager.  Discussions are around my current CEA levels, how I'm feeling, how my side effects are going, and what I need from them.   


  


I adore my team.  They are amazing, and have my full confidence.  If you're in the Phoenix area, you might see them both on CTCA commercials that were filmed last month.  Not sure when they will be airing, or if they will only be in Phoenix.  

Okay - once we have orders for chemo from Dr. Schildt, my naturpoath, Dr. Adam, comes in to talk side effects, etc.  I really like him - he's soft-spoken, but confident and honest.  Once we are done with Dr. Adam, we talk with Barbara, my nutritionist.  Again - amazing person to work with.  This process of meeting with my team can take anywhere from an hour to an hour-and-a-half.  

After we finish up with all of that, we head to scheduling to get the next round of chemo and any other appointments taken care of.  They only schedule one round ahead, since they never know what's going to happen from round to round.  


Trying to schedule everything isn't as easy as it sounds - between infusion, meetings with my med-onc team, chiropractor twice a week, O/T twice a week, massage, acupuncture, and now speech therapy (to work on my chemo brain), it takes a bit to figure it all out.  This can take upwards of 30 minutes.  

I just realized that, in the pictures above, my port has already been accessed.  On this particular day, they had pulled blood work prior to my med-onc appointment.  Moving forward (starting next week), I'll be doing lab draws a day or two before my meeting with the team, in order to cut down on the waiting time between appointments at CTCA on the day of infusion.  There is a mandatory two-hour spacer built in between lab draw/port-access and medical appointments, and since the combined time between meeting with the team and infusion is already 6-8 hours, I figured having them poke me with a needle the day prior is worth two hours of my time on the day of infusion.  

Port access - this sucks.  If you're squeamish, you might want to skip this paragraph.  Just a warning....won't get too graphic, but you know - better safe than sorry.

Before I even leave the house for CTCA, I slather Elma cream on my port.  This helps numb the area, so I don't feel the huge needs get stuck in my chest.  The cream has to be on my port for at least an hour, and once the cream is on, I cover it with Saran wrap to make sure it gets absorbed into the skin.  If you've ever had a tattoo, it's the same concept of when you are done and they slather you up, then wrap you up.  I have actually had folks ask me if I just had a tattoo done when I'm out and about with my Elma cream on.  I should make up a kick-ass story, but I just tell them the truth.

This cream is awesome, because I literally don't feel a thing when they poke me, which is good, given that I don't really like needles all that much.  

So, I get to the port-access room and the first thing I get is mints.  It helps mask the taste and smell of the saline when they flush the port.  What does flushing the port mean?  I'm so glad you asked.  Bear with me.

 
 
To maintain a sterile environment, both the nurse and I wear face masks, to try to cut down on the number of germs that are in and around my needle area.  This is especially important as my white blood counts starts to get compromised by the chemo.  (If you remember from my chemo in 2008, I had a wicked time with a port infection.)  The nurse will clean the area, then tells me to pop a mint.  In the needle goes (it's more mentally difficult than anything, since I don't feel it), and we get started.  

This is the way the port works.  Thought this might help you understand...

She gets the needle in, gets everything situated and packaged up.  They use a special dressing on me, because my skin has become very sensitive to the adhesive glue on normal bandages and tape.  It's fun. (Blech.)  The nurse confirms that she can not only get stuff into the port but can also pull blood from it.  When she flushes the port, she injects saline into the port.  For some folks, this doesn't affect them.  For others, this causes a salty, gross, dirty-feet taste and/or smell.  This is what I deal with - taste and smell.  It's DISGUSTING!  The only thing (for me) that helps alleviate this is mint.  

Side note:  This past treatment, I forgot my mint when they flushed my port.  Instead, the nurse had me try a cherry lollipop to get the taste out of my mouth.  This.  Did.  Not.  Work.  Ha - lesson learned.  Nausea before you even start chemo does not make for a good way to start.  I promise you that.

Ok - so, we get done with the port access, and we get ready to go back into infusion.  

 The long walk back to infusion.  *sigh*  I have NO idea what I'm doing here...laughing, maybe?  



When I first get to infusion, they get vitals again (height, weight, bp, etc.).  Then, I get walked over to my infusion cube, and get settled.  


This was right after she flushed my port, and the nausea kicked in.  See how pale I am?  Yes.  I thought I was going to be sick.  Poor Natty...luckily, this calmed down after a bit.  


Mom and Dad and I, in the infusion room.  I can't thank them enough for what they've done for me, and for helping me through this.  Couldn't do it without them.....no doubt about that.

On this particular visit, my chiropractor Chuck came up to do my adjustment while I was hooked up to my pre-meds.  My pre-meds are anti-nausea meds, anti-heartburn meds, Benadryl (to make sure my body doesn't immediately and completely reject the chemo), etc.  I have about a half-hour of pre-meds before they start the chemo, so this is a good time for the chiro appt.  :)


He's not shooting me, I promise.  It's a machine that helps him adjust my back.  I adore my chiropractor...


One of the many benefits to CTCA is the capability to get food and drinks while you're getting chemo.  They offer up just about anything you could want - full-on meals (this is me, figuring out what I want for lunch), smoothies, coffee, etc.  Sometimes, I only want fruit salad.  Other times, I want a full-on meal.  I think on this day, Natty and I had chicken quesadillas.  Yum.  It seems like a small thing, but when you've been in another facility that bans food and drinks, this makes all the difference.  And, when you're nauseous, sometimes, the only thing that helps settle your stomach is food.  That's often the case for me....snacking helps.  A ton.  It doesn't help my waistline, but I figure I can work on that once I beat cancer again.


Ah, yes.  There's the quesadilla.  And, my savior, Diet Dr. Pepper.  I've NEVER been a fan of Dr. Pepper. Since this all started, though...yes, the Doctor and I are good friends.  Apparently, according to my friend Jena, this is good with vanilla vodka.  I will be trying this.  :) 


Another nice part of  this facility is that there is room enough for my family to be there with me.  Dad usually brings his laptop, Mom brings her tablet, and I watch the tv in the chemo cube.  It works out.  Oh - in this picture above, you'll see the bag from the pharmacy.  CTCA has an on-site pharmacy that fills all of my current scripts.  On this day, I had several to get filled.  They brought them right up into the infusion room for me.  Awesome....it's nice because I don't have to worry about getting down there before they close, or going back during the week I'm feeling crappy.  


The chemo and meds they pump into me always, ALWAYS, make me cold.  They provide warm blankets, and they also have an in-room warming unit (see the tubing behind me in the picture above?) that literally pumps warm air at you - I usually put it under my blanket.  So awesome.  It can also pump cold air into you.  Such a wonderful amenity.  


Eventually, with them pumping so many meds and fluids into you, you'll have to pee.  But, with the meds they put in me, I'm not always stable on my feet.  So, I need help getting to/from the bathroom.  Dad and Mom are angels, I tell you.  This is me and Dad, walking with my chemo IV, back from the restroom.  

In all honesty, I always feel really good walking into the infusion room; it's been almost two weeks since the last chemo, and I'm back to "normal", or whatever my new version of normal is.  By the time I leave chemo, I'm exhausted.  They have pumped pre-meds into me, then Avastin, Ironitican, and Leukovorin.  Those drugs make me tired, weak, nauseous, and miserable.  But, they are essential to helping me make sure I have the best shot at kicking cancer' ass once again.  I get that, but I don't have to like it.


As much as I wanted to spend time with Natty and make sure she blocked out time for herself and her family on her calendar (LOL), I zonked.  Between the Benadryl and the Ativan I asked for to help settle my tummy, I was out cold.  She apparently took this picture just before she left.  I'm sorry I wasn't conscious to say goodbye to her, or to thank her.  It was wonderful spending the day with her, but I *so* wish it wasn't at chemo.  

So, that's a day in my life of chemo, day one.  I'll try to get pictures this next round of my pump, etc.  I'll admit, writing this all down has been easier than I though.  But, I also took a lot longer to get this down in words than I wanted to.  I don't like that I'm going through this.  I hate that I look like a chemo patient, not because I'm ashamed, but because I don't like looking like a chemo patient.  No rhyme or reason....it just is.  

Any questions?  :)

Comments:

Mrs. Buv said...

"As much as I wanted to spend time with Natty and make sure she blocked out time for herself and her family on her calendar (LOL)..." How true is THIS!!

Love you so much!! I hope I can steal a day with you...maybe give your parents a break!!

xoxo
May 11, 2012 at 8:43 PM

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